Grahn Kronhed AC, Möller M. Effects of physical exercise on bone mass, balance skill and aerobic capacity in women and men with low bone mineral density, after one year of training - a prospective study.
Vadstena is a small community in the county of östergötland, Sweden, where a project began in 1989 to prevent osteoporosis and to lower the expected incidence of osteoporotic fractures. Persons aged 40–70 years who had a low bone mineral density (BMD) value at screening of the distal radius by single-photon absorptiometry (SPA) were invited to participate in a training study during one year. The definition of low BMD was a densitometry value below −1 SD (standard deviation) from a sex- and age-specific reference value (z-score). Fifteeen persons wanted to exercise in a group and 15 persons wanted to become a control group. All participants answered a questionnaire about lifestyle, occupation, diseases, medication and heredity. Clinical tests were made regarding mobility of the joints and muscles, balance and physical fitness. BMD for the hip and the lumbar spine were assessed by dual-energy X-ray absorptiometry (DXA) before and after the investigation period. The training programme was carried out for 60 min twice a week during one year and had the intention to improve bone mass, muscle strength and flexibility, balance skill and aerobic capacity. After the training period there was a significant increase in BMD at the greater trochanter (P<0.01), in balance skill (standing on one leg with closed eyes and “ski step“-test) (P<0.05) and in oxygen uptake capacity (P<0.05) in the exercise group. In the control group, there was a significant increase in BMD at the lumbar spine (P<0.05). However, these results should be judged with caution because several participants were over the age of 60, and at that age degenerative changes in the lumbar spine may increase to a greater or lesser extent. Regular weight-bearing exercises during one year seem to influence BMD at the greater trochanter in a training group comprising both women and men. However, our study was small in number and further training studies are needed to assess the effect of weight-bearing training on bone mass in different sex- and age-specific groups.
"The exercises should be safe to minimise the risk of arthritic complications, falls and fractures. It is important that the physiotherapist individualises the loading when training equipment and weights are used (Englund et al. 2005, Grahn Kronhed et al. 1998, Hourigan et al. 2008, Malmros et al. 1998). "
[Show abstract][Hide abstract] ABSTRACT: The use of physical activity is widely accepted in preventive medicine practice. Therapeutic exercises are especially beneficial in supporting the treatment of some chronic diseases. The choice of appropriate and effective exercises in the treatment and prevention of osteoporosis is crucial. The duration, intensity, frequency, and the involved muscle mass are to be taken into account in the prescription of exercises, which are basically a combination of movement patterns. The musculo-skeletal system is in continuous interaction with the environment. It is a very dynamic system with a high adaptive capacity. The response to stimuli depends on the biological age, health, and sports activity experience of the individual. Weight bearing activities with different movement patterns like ball games are accepted to be more effective in the prevention of osteoporosis, especially when performed till the end of puberty. This type of activity seems to be also effective in the middle-aged. Porprioceptive and strength exercises are important in supporting postmenopausal women. In elderly people, though progressive resistance exercises are very effective, even walking and simple gymnastics can be beneficial in more sedentary cases. Less intensive exercise of shorter duration have to be performed by people with advanced stage osteoporosis with or without previous fracture complication. Strength exercises can be fulfilled isometrically in critical cases.
[Show abstract][Hide abstract] ABSTRACT: Osteoporosis and fractures due to osteoporosis are an increasing global health problem. The aim of the ten-years Vadstena Osteoporosis Prevention Project (VOPP) was to evaluate if it was possible to reduce osteoporosis and osteoporotic-related fractures with a community-based prevention program A representative sample aged 20-79 years (Vadstena population of 7800) was invited to participate in the study comprising four measurements including questionnaire and bone mineral density measurement. At baseline 70% participated, at first follow-up 69%, second follow-up 70% and at the third follow-up 65 %. The aim with this MPH- essay is to describe the intervention from a diary and to present the populations experience of the VOPP. We met approximately 5000 persons (65%) of the citizens directly with our intervention. The participators who received individual feedback letters on their answers in the questionnaire and the results from the bone measurement gave us the best response. The group that participated once or more had the best knowledge about osteoporosis (p< 0.001) and were to an high extent familiar with the project (p
[Show abstract][Hide abstract] ABSTRACT: AVEIRO, M.C., NAVEGA, M.T., GRANITO, R.N., RENNÓ, A.C.M., OISHI, J. The effects of a physical exercise program on the balance, on the quadriceps muscle strength and on the quality of life in osteoporotic women. R. bras. Ci.e Mov. 2004; 12(3): 33-38. The purpose of this study was to analyse the effects of a physical exercise program to improve muscle strength of quadriceps, balance and quality of life of osteoporotic women. 16 women with densitometric diagnosis of osteoporosis in the spine and/or femur, with 60 - 74 years of age (67.2 ± 3.7), participated in this study. All subjects were submitted to an extension muscle torque evaluation, through a BIODEX isokynetic dynamometer, to a balance evaluation and answered a quality of life questionaire (OPAQ). Afterwards they were submitted to the physical training, orientated by a physiotherapist, during 12 weeks, with a frequency of three times per week. Each session included walking, stretching exercisers and exercisers to the extension muscles of the knee. After this period, the subjects were evaluated. The data were statiscally analyzed by Wilcoxon nonparametric test and showed significant difference between evaluations (p< 0,05). The results found in this study allow concluding that the physical exercise program was efficient to improve the extension muscles torque of the knee, balance and quality of life of osteoporotic women, suggesting to be an effective and safe training program to osteoporotic women.
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